CLINICAL AND PATHOGENETIC RATIONALE FOR A STUDY OF THE SECRETION OF ANGIOGENIC FACTORS IN THE LUTEAL PHASE OF THE MENSTRUAL CYCLE IN WOMEN WITH A HISTORY OF REPEATED EARLY PREGNANCY LOSSES

Objective. To analyze the serum level of vascular endothelial growth factor (VEGF) in patients with a history of recurrent miscarriage (RM). Subjects and methods. This was a prospective cohort study. Sixty-two women with a history of early pregnancy losses and 32 healthy puerperas underwent an examination of the immune status and pro- and antiangiogenic factors and ultrasonography with Doppler study of uterine vessels in the secretory phase of the menstrual cycle. Pregravid preparation was used after randomization. Results. In the secretory phase of the menstrual cycle, the women with a history of RM were found to have a large number of cells with CD56+ phenotype and impaired uterine hemodynamics along with the low level of the proangiogenic factor VEGF with the normal values of antiangiogenic factors. Methylprednisolone, as compared to imunofan, considerably enhanced VEGF secretion at the preimplantation stage. There was a correlation of VEGF with endometrial thickness, uterine hemodynamics, and cytotoxic cell levels with CD56+ phenotype. Conclusion. Peripheral blood VEGF level should be measured in women with recurrent first-trimester pregnancy losses, immune status imbalance, and impaired uterine hemodynamics in the secretory phase of the menstrual cycle. When the VEGF level is low, it is expedient to administer methylpredlisolone methylprednisolone 8 mg/day from day 1 to day 25 of the menstrual cycle as part of combination pregestational preparation.

vascular endothelial growth factor, angiogenic factors, recurrent miscarriage, methylprednisolone